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"Hennessy, Erin"
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A review of the ketogenic diet for endurance athletes: performance enhancer or placebo effect?
2020
Background
The ketogenic diet has become popular among endurance athletes as a performance enhancer. This paper systematically reviews the evidence regarding the effect of the endurance athlete’s ketogenic diet (EAKD) on maximal oxygen consumption (VO
2
max) and secondary performance outcomes.
Methods
PubMed and Web of Science searches were conducted through November 2019. Inclusion criteria were documentation of EAKD (< 50 g daily carbohydrate consumed by endurance athletes), ketosis achieved (measured via serum biomarker), VO
2
max and/or secondary outcomes, English language, and peer reviewed-publication status. Articles were excluded if they were not a primary source or hypotheses were not tested with endurance athletes (i.e., individuals that compete at submaximal intensity for extended time periods). Study design, diet composition, adherence assessment, serum biomarkers, training protocols, and VO
2
max/secondary outcomes were extracted and summarized.
Results
Searches identified seven articles reporting on VO
2
max and/or secondary outcomes; these comprised six intervention trials and one case study. VO
2
max outcomes (
n
= 5 trials,
n
= 1 case study) were mixed. Two of five trials reported significant increases in VO
2
max across all diets; while three trials and one case study reported no significant VO
2
max findings. Secondary outcomes (
n
= 5 trials,
n
= 1 case study) were Time to Exhaustion (TTE;
n
= 3 articles), Race Time (
n
= 3 articles), Rating of Perceived Exertion (RPE;
n
= 3 articles), and Peak Power (
n
= 2 articles). Of these, significant findings for EAKD athletes included decreased TTE (
n
= 1 article), higher RPE (
n
= 1 article), and increased Peak Power (
n
= 1 article).
Conclusion
Limited and heterogeneous findings prohibit definitive conclusions regarding efficacy of the EAKD for performance benefit. When compared to a high carbohydrate diet, there are mixed findings for the effect of EAKD consumption on VO
2
max and other performance outcomes. More randomized trials are needed to better understand the potentially nuanced effects of EAKD consumption on endurance performance. Researchers may also consider exploring the impact of genetics, recovery, sport type, and sex in moderating the influence of EAKD consumption on performance outcomes.
Journal Article
Community-led change: Progress toward policy, systems, and environmental impacts through the Catalyzing Communities initiative
by
Hennessy, Erin
,
Moore, Travis R.
,
Sanderson, Emily
in
Biology and Life Sciences
,
Capacity Building
,
Capacity development
2025
This study evaluated progress toward policy, systems, and environmental (PSE) changes through community-led actions supported by the Catalyzing Communities initiative, guided by Stakeholder-Driven Community Diffusion (SDCD) theory. Objectives included assessing community action implementation, evaluating SDCD-informed strategies' role in enhancing capacity, and identifying contextual factors influencing progress towards PSE changes.
Catalyzing Communities engaged 23 key partners across eight U.S. communities. These partners led committees of 110 local champions and integrated local insights and resources into community-led actions. Capacity-building strategies supported action prioritization and implementation.
A mixed-methods approach included web surveys and follow-up interviews. Surveys assessed action implementation, while interviews explored impacts and contextual factors. Data were analyzed using thematic analysis, supported by an iteratively developed codebook and double coding.
Fourteen changemakers completed surveys and ten participated in interviews. They led 82 local champions across six communities in prioritizing and implementing 21 community-informed actions. Actions differed across communities based on local priorities, including enhancing early childhood and school programs, improving food access, promoting active living, and fostering community connections. Most actions were ongoing, in progress at the time of data collection, and partially successful in reaching target populations. Capacity-building strategies - such as peer networking, tools like causal loop diagrams, and technical assistance - were critical for building relationships, enhancing systems thinking, and securing funding. Contextual factors, including committee synergy, readiness, organizational capacity, and the impact of COVID-19, shaped progress toward PSE changes.
Journal Article
Tracing coalition changes in knowledge in and engagement with childhood obesity prevention to improve intervention implementation
by
Economos, Christina D.
,
Hennessy, Erin
,
Moore, Travis R.
in
Biostatistics
,
Childhood
,
Childhood obesity
2022
Background
While most coalition research focuses on studying the effects of peer relationship structure, this study examines the coevolution of coalition structure and behavior across three communities in the U.S. with the goal of identifying coalition dynamics that impact a childhood obesity prevention intervention.
Methods
Over two years (2018–2020), three communities within the U.S. participated in a childhood obesity prevention intervention at different times. This intervention was guided by the Stakeholder-Driven Community Diffusion theory, which describes an empirically testable mechanism for promoting community change. Measures are part of the Stakeholder-driven Community Diffusion (SDCD) survey with demonstrated reliability, which include knowledge of and engagement with childhood obesity prevention and social networks. Data from three coalition-committees and their respective networks were used to build three different stochastic actor-oriented models. These models were used to examine the coevolution of coalition structure with coalition behavior (defined a priori as knowledge of and engagement with obesity prevention) among coalition-committee members and their nominated alters (Network A) and coalition-committee members only (Network B).
Results
Overall, coalitions decrease in size and their structure becomes less dense over time. Both Network A and B show a consistent preference to form and sustain ties with those who have more ties. In Network B, there was a trend for those who have higher knowledge scores to increase their number of ties over time. The same trend appeared in Network A but varied based on their peers’ knowledge in and engagement with childhood obesity prevention. Across models, engagement with childhood obesity prevention research was not a significant driver of changes in either coalition network structure or knowledge.
Conclusions
The trends in coalition Network A and B’s coevolution models may point to context-specific features (e.g., ties among stakeholders) that can be leveraged for better intervention implementation. To that end, examining tie density, average path length, network diameter, and the dynamics of each behavior outcome (i.e., knowledge in and engagement with childhood obesity prevention) may help tailor whole-of-community interventions. Future research should attend to additional behavioral variables (e.g., group efficacy) that can capture other aspects of coalition development and that influence implementation, and to testing the efficacy of network interventions after trends have been identified.
Journal Article
Design and methods of Shape Up Under 5: Integration of systems science and community-engaged research to prevent early childhood obesity
by
Hennessy, Erin
,
Tovar, Alison
,
Hovmand, Peter S.
in
Biology and Life Sciences
,
Building design
,
Care and treatment
2019
Shape Up Under 5 (SUU5) was a two-year early childhood obesity prevention pilot study in Somerville, Massachusetts (2015-2017) designed to test a novel conceptual framework called Stakeholder-driven Community Diffusion. For whole-of-community interventions, this framework posits that diffusion of stakeholders' knowledge about and engagement with childhood obesity prevention efforts through their social networks will improve the implementation of health-promoting policy and practice changes intended to reduce obesity risk. SUU5 used systems science methods (agent-based modeling, group model building, social network analysis) to design, facilitate, and evaluate the work of 16 multisector stakeholders ('the Committee'). In this paper, we describe the design and methods of SUU5 using the conceptual framework: the approach to data collection, and methods and rationale for study inputs, activities and evaluation, which together may further our understanding of the hypothesized processes within Stakeholder-driven Community Diffusion. We also present a generalizable conceptual framework for addressing childhood obesity and similar complex public health issues through whole-of-community interventions.
Journal Article
Parent-child interactions and objectively measured child physical activity: a cross-sectional study
by
Economos, Christina D
,
Hennessy, Erin
,
Hughes, Sheryl O
in
Behavioral Sciences
,
Children
,
Children & youth
2010
Background
Parents influence their children's behaviors directly through specific parenting practices and indirectly through their parenting style. Some practices such as logistical and emotional support have been shown to be positively associated with child physical activity (PA) levels, while for others (e.g. monitoring) the relationship is not clear. The objectives of this study were to determine the relationship between parent's PA-related practices, general parenting style, and children's PA level.
Methods
During the spring of 2007 a diverse group of 99 parent-child dyads (29% White, 49% Black, 22% Hispanic; 89% mothers) living in low-income rural areas of the US participated in a cross-sectional study. Using validated questionnaires, parents self-reported their parenting style (authoritative, authoritarian, permissive, and uninvolved) and activity-related parenting practices. Height and weight were measured for each dyad and parents reported demographic information. Child PA was measured objectively through accelerometers and expressed as absolute counts and minutes engaged in intensity-specific activity.
Results
Seventy-six children had valid accelerometer data. Children engaged in 113.4 ± 37.0 min. of moderate-vigorous physical activity (MVPA) per day. Children of
permissive
parents accumulated more minutes of MVPA than those of
uninvolved
parents (127.5 vs. 97.1,
p
< 0.05), while parents who provided above average levels of support had children who participated in more minutes of MVPA (114.2 vs. 98.3,
p
= 0.03). While controlling for known covariates, an
uninvolved
parenting style was the only parenting behavior associated with child physical activity. Parenting style moderated the association between two parenting practices - reinforcement and monitoring - and child physical activity. Specifically, post-hoc analyses revealed that for the
permissive
parenting style group, higher levels of parental reinforcement or monitoring were associated with higher levels of child physical activity.
Conclusions
This work extends the current literature by demonstrating the potential moderating role of parenting style on the relationship between activity-related parenting practices and children's objectively measured physical activity, while controlling for known covariates. Future studies in this area are warranted and, if confirmed, may help to identify the mechanism by which parents influence their child's physical activity behavior.
Journal Article
The impact of a community social marketing campaign on children’s meal orders and consumption: main outcomes from a group randomised controlled trial
by
Chui, Kenneth
,
Roberts, Susan
,
Economos, Christina D
in
Advertising campaigns
,
Audiences
,
Calories
2023
Restaurants may be important settings for interventions to reduce children's energy intake. The objective of this study was to test the impact of a parent-focused social marketing campaign to promote healthy children's meals on calories ordered and consumed by children at quick-service restaurants (QSR).
Using a repeated cross-sectional study design, two urban communities were randomised to intervention (IN)
. control (C) condition. A community-wide social marketing campaign was implemented in the IN community to empower Black and Latinx mothers who frequent QSR (priority population) to select healthier options for their child.
Data were collected in 2016 at QSR located within the communities pre- and post-IN and analysed in 2017.
Parents (
1686;
819 and
867 for I and C conditions, respectively) were recruited after placing their QSR order; a survey, receipt and their child's leftovers were collected.
Calories ordered did not differ significantly between the IN and C conditions (change
= -146·4 kJ (-35·0 kcal); 95 % CI -428·0 kJ (-102·3 kcal), 134·6 kJ (32·2 kcal)). In a sub-analysis of only the priority audience, children in the IN community ordered significantly fewer calories compared to C children in unadjusted models (change
= -510·4 kJ (-122·0 kcal); 95 % CI -1013·4 kJ (-242·2 kcal), -7·5 kJ (-1·8 kcal)), but the trend did not persist after adjusting for covariates (change
= -437·2 kJ (-104·5 kcal); 95 % CI -925·5 kJ (-221·2 kcal), 50·6 kJ (12·1 kcal)). Calories consumed followed similar trends.
The campaign did not significantly reduce children's QSR calories ordered or consumed. However, a quantitatively important mean reduction in calories was suggested among the priority audience, indicating potential for community-wide promotion of healthful children's meals.
Journal Article
The Effect of Timing of Exercise and Eating on Postprandial Response in Adults: A Systematic Review
by
Bhadra, Anindya
,
Hennessy, Erin
,
Gelfand, Saul
in
administrative management
,
adults
,
behavior modification
2020
Type 2 diabetes is a major public health concern. Management of this condition has focused on behavior modification through diet and exercise interventions. A growing body of evidence has focused on temporality of dietary intake and exercise and potential effects on health. This review summarizes current literature that investigates the question “how does the timing of exercise relative to eating throughout the day effect postprandial response in adults?” Databases PubMed, Scopus, Cochrane Library, CINAHL, and SPORTDiscus were searched between March–May 2019. Experimental studies conducted in healthy adults (≥18 y) and those with type 2 diabetes were included. Full texts were examined by at least two independent reviewers. Seventeen studies with a total of 332 participants met the inclusion criteria. The primary finding supports that exercise performed post-meal regardless of time of day had a beneficial impact on postprandial glycemia. There was insufficient evidence regarding whether timing of exercise performed pre- vs. post-meal or vice versa in a day is related to improved postprandial glycemic response due to inherent differences between studies. Future studies focusing on the investigation of timing and occurrence of meal intake and exercise throughout the day are needed to inform whether there is, and what is, an optimal time for these behaviors regarding long-term health outcomes.
Journal Article
College campuses' influence on student weight and related behaviours: A review of observational and intervention research
by
Economos, Christina D.
,
Hennessy, Erin
,
Simon, Caitlin
in
Body mass index
,
Body weight gain
,
college
2020
Summary Research indicates that most college students are not meeting dietary and physical activity guidelines, and the average student gains an estimated 1.6–3.0 kg during 4 years of study. College administrations are well‐positioned to influence student weight‐related health behaviours by ensuring that campus environments/policies promote health. However, to date, campus health interventions have largely addressed individual and interpersonal factors rather than environmental/policy‐level changes. Using an ecological perspective, this narrative review synthesizes the literature on campus environmental/policy‐level factors (e.g., food availability, physical activity requirements) associated with student diet, physical activity and weight, as well as campus interventions to address these factors. Web of Science and PubMed databases were searched between December 2018 and November 2019. Results indicate that campus food environments may contribute to overconsumption and weight gain, and the number of campuses requiring students to participate in physical activity courses is in decline. Eight examples of environmental/policy‐level campus interventions are presented: nutrition labels in dining halls, campus‐wide healthy choice marketing campaigns, restricted payment methods for à la cart dining, trayless dining, health‐themed residence halls, peer health education programmes, active classroom spaces and physical activity course requirements. Implications for research and health promotion programmes/policies in the field of college health are discussed.
Journal Article
Potential Climate and Human Water-Use Effects on Water-Quality Trends in a Semiarid, Western U.S. Watershed: Fountain Creek, Colorado, USA
2024
Nutrients, total dissolved solids (TDS), and trace elements affect the suitability of water for human and natural needs. Here, trends in such water-quality constituents are analyzed for 1999–2022 for eight nested monitoring sites in the 24,000 km2 Fountain Creek watershed in Colorado, USA, by using the weighted regressions on time, discharge, and season (WRTDS) methodology. Fountain Creek shares characteristics with other western U.S. watersheds: (1) an expanding but more water-efficient population, (2) a heavy reliance on imported water, (3) a semiarid climate trending towards warmer and drier conditions, and (4) shifts of water from agricultural to municipal uses. The WRTDS analysis found both upward and downward trends in the concentrations of nutrients that reflected possible shifts in effluent management, instream uptake, and water conservation by a watershed population that grew by about 40%. Selenium, other trace elements, and TDS can pose water-quality challenges downstream and their concentrations were found to have a downwards trend. Those trends could be driven by either a warming and drying of the local climate or decreased agricultural irrigation, as both would reduce recharge and subsequent mobilization from natural geologic sources via groundwater discharge. The patterns illustrate how changes in climate and water use may have affected water quality in Fountain Creek and demonstrate the patterns to look for in other western watersheds.
Journal Article
Patterns of food parenting practices regarding junk food and sugary drinks among parent-child dyads
2020
Background
Children’s food preference and intake patterns are affected by parental child feeding practices. The objective was to determine patterns of food parenting practices regarding junk food and sugary drinks (JS) and investigate their associations with demographic characteristics and dietary intake in a large cohort of parents and their children (12–17 years).
Methods
Dyadic survey data from the cross-sectional, internet-based Family Life, Activity, Sun, Health, and Eating Study, conducted in 2014, were analyzed using latent class analysis to identify patterns of use for six JS parenting practices – negative emotions, restriction, monitoring, availability, modeling, and child involvement – based on parent and child report. Model covariates included self-reported parent and child sex, age (child only), body mass index category (based on height and weight), added sugars intake, and legitimacy of parental authority.
Results
Based on 1657 parent-child dyads, five parenting practice patterns were identified representing different levels of practice use – Complete Influencers (28%; reference class), Indifferent Influencers (21%), Negative Influencers (20%), Minimal Influencers (18%), and Disagreeing Influencers (13%). Compared to older child dyads, younger child dyads were less likely to belong to Indifferent and Minimal Influencers (79 and 63% lower odds, respectively). Greater parent added sugars intake increased the odds of belonging to Indifferent and Negative Influencers (4 and 5% higher for every teaspoon increase, respectively) while greater child added sugars intake decreased the odds of belonging to Minimal Influencers (6% lower for every teaspoon increase). Compared to dyads with high scores, dyads with low child scores for legitimacy of parental authority regarding JS were 18 times as likely to belong to Disagreeing Influencers.
Conclusions
The study findings suggest that parents utilize distinct patterns of feeding practices regarding JS ranging from use of many practices, use of some practices, to low use of any practice, with differential associations with parent and child intakes of added sugars. Counseling or intervening with parents to use a mix of structure practices, such as availability and modeling, to positively influence their child’s and possibly their own intake of sugary snacks and drinks may prove more efficacious than use of coercive control practices, such as negative emotions.
Journal Article